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{ <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERE'TT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATION9 ARE ACCEPTED FROM!AM TO 4 PM <br /> SITEADDRESS: /� .�T�� �, V. PROPERiYTA%II PERMITR _ � <br /> GJ <br /> LEGAL lor new constnxtiore Stwr1 PWVsubOivision LW No._ (attach wpy ollorq k9+��Nb^) <br /> OVYNER PMne�E-rtuil <br /> Cdres� CIy/S�atUZip <br /> CONTRACTOR ('q Yi� L 6 I Uc./ � S S <br /> � PhwblEmail <br /> aaress ' � � �io . � 1 � <br /> TENANT BU INES AME C NTACT O P RMIT <br /> ��/� zzt�4 -49s-t5y i <br /> •' ���G GN PMne/E�meil <br /> BUILDING PERMIT APPIICATION CONttucTrrtlCEOFwoRK � d��� <br /> Ezisting Use ot Building�c HFAT SOURCE: <br /> Proposed Use ot Buiiding 2f1�"�vn n Gas Ekwtric Otha <br /> Building type: _Single Family _Duplez_Townhousa _Multi-Family ,�Commercial <br /> Type of projecl: ,�' New _Addition _Remodel _Repair_T.I._Sipr�_Sprinkler_DemolOion_Change of Uee <br /> Desuiption ot Work(e40ifional spare prowded n fhe back): <br /> Y�s�a1 �'yp� 1 N� s�s��.., ,mu.b . a� r_o�Q ��� �xl�k�,.s�- d�..z�. <br /> Have you ahRed worklnp withouf a permil7 �YES _NO �J o'�" �� C, GT. <br /> MECIIANICAL PERMIT APPLICATION PLUMdING PERMIT APPLICATION <br /> TypeolProJeet:�New_AAAn _Alteretlon_Repeir Typ�olProJact: _New_AAEn _MbrHlon_Rep�ir <br /> SAow Number pJ ol fltlurea Show NumMr ol flrturs <br /> AIC—airhandlin units Toikt <br /> Forced air s stems Bathtub <br /> Gas i in Levalo waeh baein <br /> � Water heater Shower <br /> � Gas fire lace Kdchen sink 3 dia wal <br /> Gas ran e Diahwasher <br /> Clothes d er Clothea washer <br /> Ran e hood Water heater <br /> Exhauattan Sink serviceibarlmo /etc. <br /> Heat um Backflow reveMer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eralion Floordrain <br /> WooOstove Grease tra <br /> Ductin Rool drains <br /> � Other Mediwl Gas <br /> SPRINKL[R/sUPPRESSION SYSTEM other: <br /> Number o(Heads Other: <br /> I hereby certiry ihat I have read enE e:amine0 ihis application anC know Ihe same to be ime and corred.All pmvisions of law�enA orUinances poveninp <br /> this type ol work will be complied wilh w�ether epecifetl berein or not The prantinB ol a pe�mit dces nol presume lo give authority to violate or cancel <br /> the provision ol any other slate or local law repulaling construction or the pedormance of construction.That I am authorize0 by the owner ol t�ia property <br /> lo Aorm Ihe vroM for ilch application In made anA I comply with lhe Slete Conhactors Law 18.27 RCW and 2B8.20U WAC <br /> `'ll lc�-- Z—L�—l7i <br /> O rlAulhorized Agent SI nHurs Date (Revised 712017) <br />